Progress And Clinical Observation Of The Combination Of Traditional Chinese And Western Medicine For Early Renal Damage In Patients With Essential Hypertension

This dissertation is composed of two parts:the review articles and a clinical research.Part one:Review articlesDiscuss the Chinese and Western medicine advancement of essentional hypertension with early renal damage.As the number of essentional hypertension patients growing,the morbidity of early renal damage is increasing.If the disease haven't been observed and controlled in time,it will evolve into ESRD and add the risk of cardiovascular events and stroke.The part one introduces the epidemiology, the correlation between the target organ damages, the pathematology,nosogenesis,influencing factos,diagnose,western medicine treatment and Chinese medicine progession.Part two:clinical researchObjective:research the influencing factors of AASI.Analyze the relationship between AASI and eGFR,ACR to supply evidence for AASI as a predictor of early renal damage.Investigate the relationship between AASI and TCM pattern of syndrome.Methods: Select eligible104cases of essential hypertension with early renal damage; carry out statistical analysis to result of age,sex,blood stage,dangerouslevel,height,weight,waistline,Scr,24hSBP,24hDBP,24hMBP,BMI,HDL-C,LD L-C,TG,TC,AASI,eGFR,ACR and Chinese pattern syndrome with SPSS17.0, Excel statistical analysis software.A group is defined as AASI>0.55and B group is defined as AASI<0.55.Results:(1)The A group showed higher age(P<0.01),course of disease(P<0.01), ACR (P<0.01),ACR(+) rate(P<0.01),HDL-C(P<0.05) and lower eGFR(P<0.01),24hDBP(P <0.05) compared with the B group. The higher dangerous level has a higher AASI than lower lever(P<0.05).(2)AASI showed a positive correlation with age (r=0.483P=0.000),course (r=0.212, P=0.048),24hSBP (r=0.350, P=0.001),ACR (r=0.474, P=0.000),and a negative correlation with eGFR (r=-0.383, P=0.000).Two multiple linear regressions showed that AASI was associate with eGFR(B=-0.001,P=0.038) and ACR(B=0.029,P=0.000) independent of other factors.(3) The spread of TCM syndrome type of essential hypertension with early renal damage is blood stasis type> yin yang deficiency type>excessive accumulation of phlegm dampness type=hyperactivity of liver yang type>yin deficiency with yang excess type.Age in blood stasis type,yin yang deficiency and yin deficiency with yang excess tye is all higher than excessive accumulation of phlegm dampness(P<0.05). Weight and BMI in excessive accumulation of phlegm dampness and hyperactivity of liver yang type are both higher than yin yang deficiency.TG in excessive accumulation of phlegm dampness is higher than yin and yang deficiency type(P<0.01).Conclusion:(1) The higer AASI is,the higher age,course of disease, ACR,ACR(+) rate is and the lower eGFR is. The higher dangerous level has a higher AASI than lower lever.(2) AASI showed a positive correlation with ACR and a negative correlation with eGFR,Two multiple linear regressions showed that AASI was associate with eGFR(B=-O.001,P=0.038) and ACR(B=0.029,P=0.000) independent of other factors.And AASI is a predictor of early renal damage.(3)Among all the five syndrome types, blood stasis type is the most,with yin yang deficiency type afer it.